Trepanation and curettage treatment for acute implant periapical lesions

Zhou, Yanmin; Cheng, Zhe; Wu, Min; Zhou, Hong; Gu, Zhiyuan

doi:10.1016/j.ijom.2011.09.013

Cited by 12 publications

(15 citation statements)

References 14 publications

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“…On the basis of case reports analyzed, RPI was diagnosed between 1 week and 4 years after implant placement 26 , 28 . Thirteen studies reported that RPI lesions were diagnosed within 6 months after implant placement 20,24,27‐44 . Predominant diagnostic presentation of lesion was presence of fistula at buccal or facial abscess of apical portion of implant, and subsequent periapical radiographs taken demonstrated radiolucent lesion.…”

Section: Resultsmentioning

confidence: 99%

“…In 12 of 20 case reports, the tooth that was replaced with implant, which developed RPI lesion, had previous RCT 24,27,29‐35,40,42,43 . Of 95 implants with RPI analyzed in this study, 27 implant sites had a tooth with previous RCT and 35 had teeth that did not have any endodontic treatment; whether a previously extracted tooth had any endodontic treatment history was not provided for 33 implants 20,24,27‐36,38‐45 . Five implants did not improve with treatment and were subsequently removed 20,35,36,44 …”

Section: Resultsmentioning

confidence: 99%

“…Zhou et al 40 treated six cases of RPI with surgical debridement of periapical lesion without resection of implant apex and found treatment to be successful when lesions appeared soon after implant placement. In a case report by Kutlu et al, 33 surgical debridement was attempted with GBR in treatment of RPI lesion, but the lesion did not resolve.…”

Section: Discussionmentioning

confidence: 99%

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A Novel Treatment Decision Tree and Literature Review of Retrograde Peri‐Implantitis

Sarmast¹,

Wang

Σολδάτος³

et al. 2016

Journal of Periodontology

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Background: Although retrograde peri‐implantitis (RPI) is not a common sequela of dental implant surgery, its prevalence has been reported in the literature to be 0.26%. Incidence of RPI is reported to increase to 7.8% when teeth adjacent to the implant site have a previous history of root canal therapy, and it is correlated with distance between implant and adjacent tooth and/or with time from endodontic treatment of adjacent tooth to implant placement. Minimum 2 mm space between implant and adjacent tooth is needed to decrease incidence of apical RPI, with minimum 4 weeks between completion of endodontic treatment and actual implant placement. The purpose of this study is to compile all available treatment modalities and to provide a decision tree as a general guide for clinicians to aid in diagnosis and treatment of RPI. Methods: Literature search was performed for articles published in English on the topic of RPI. Articles selected were case reports with study populations ranging from 1 to 32 patients. Any case report or clinical trial that attempted to treat or rescue an implant diagnosed with RPI was included. Results: Predominant diagnostic presentation of a lesion was presence of sinus tract at buccal or facial abscess of apical portion of implant, and subsequent periapical radiographs taken demonstrated a radiolucent lesion. On the basis of case reports analyzed, RPI was diagnosed between 1 week and 4 years after implant placement. Twelve of 20 studies reported that RPI lesions were diagnosed within 6 months after implant placement. A step‐by‐step decision tree is provided to allow clinicians to triage and properly manage cases of RPI on the basis of recommendations and successful treatments provided in analyzed case reports. It is divided between symptomatic and asymptomatic implants and adjacent teeth with vital and necrotic pulps. Conclusions: Most common etiology of apical RPI is endodontic infection from neighboring teeth, which was diagnosed within 6 months after implant placement. Most common findings, radiographically and clinically, are lesions around implant apex and sinus tract. A small number of implants did not improve with treatment. Decision tree provides a path to diagnose and treat lesions to facilitate their management. Further studies are needed to focus on histologic data around periapical microbiota to establish specific etiology and differential diagnoses compared with marginal peri‐implantitis and other implant‐related conditions.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

A Novel Treatment Decision Tree and Literature Review of Retrograde Peri‐Implantitis

Sarmast¹,

Wang

Σολδάτος³

et al. 2016

Journal of Periodontology

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“…Twelve of the articles were excluded as they had no IOPAs of the lesion. 7,11,24,25,33,35,[37][38][39]45,48,53 A total of 54 IOPAs from 36 articles were compiled. One periodontist (SR) and one implantologist (TAB) independently analyzed the IOPAs.…”

Section: Literature Searchmentioning

confidence: 99%

A Radiographic Classification for Retrograde Peri-implantitis

Shah¹,

Thomas²,

Kumar³

et al. 2016

The Journal of Contemporary Dental Practice

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Background: Retrograde peri-implantitis (RPI) is an inflammatory disease that affects the apical part of an osseointegrated implant, while the coronal portion of the implant sustains a normal bone-to-implant interface. It is a diagnostic and therapeutic dilemma for implantologists. There is lack of a standard classification system and a definite treatment algorithm for the same. This article aims to introduce a classification system for RPI based on the radiographic amount of bone loss around an implant apex. Materials and methods:A search of PubMed database was conducted with the keywords "retrograde peri-implantitis" and "implant periapical lesion." Preoperative intraoral periapical (IOPA) radiographs of implants with RPI in case reports/case series were compiled. A total of 54 IOPAs from 36 articles were compiled and were assessed.Results: Three different classes were proposed. The amount of bone loss from the apex of the implant to the most coronal part of radiolucency was calculated as a percentage of the total implant length and classified into one of the three classes: Mild, moderate, and advanced. Treatment options and prognosis have been suggested for each class. Conclusion:The proposed classification may allow for an easy and reproducible radiographic assessment of the RPI lesion and may serve as a guideline to prognosis and treatment planning.

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“…Aparte, muchos de los casos descritos en la literatura aparecen antes de iniciar la carga implantaria. Por ejemplo, en las series de Peñarrocha y Zhou, de 7 y 6 casos respectivamente, todas las PIA habían aparecido antes de la carga 16,17 . En nuestra serie sin embargo 9 de los 11 casos fueron diagnosticados tras la carga.…”

Section: Tabla 3 -Datos Clínicos De La Serieunclassified